Conversion From Tacrolimus to Sirolimus-Based Immunosuppressive Regimen in Kidney Transplant Recipients. Preliminary Results

Medina‐Pestana, José Osmar; Garcı́a, Valter Duro; David‐Neto, Elias; Carvalho, Deise De Boni Monteiro de; Contieri, Fabiana Loss de Carvalho; Abbud-Filho, Mário; Silva, Tedesco H.; Ikehara, E.

doi:10.1097/00007890-201007272-00555

Cited by 3 publications

(2 citation statements)

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“…However, one RCT comparing immediate introduction of everolimus with delayed introduction after 4 weeks in kidney transplantation found no differences in wound healing complications at 3 months or 12 months [52,53]. A number of RCTs have evaluated the late conversion to sirolimus at 3 months post‐transplant but none of these studies report on the occurrence of wound complications or lymphoceles possibly because these problems are unlikely to occur after such time period [54–56].…”

Section: Discussionmentioning

confidence: 99%

Do wound complications or lymphoceles occur more often in solid organ transplant recipients on mTOR inhibitors? A systematic review of randomized controlled trials

Pengel¹,

Liu²,

Morris³

2011

Transplant International

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Summary mTOR inhibitors have been associated with wound complications and lymphoceles. We systematically reviewed randomized controlled trials (RCTs) to compare these outcomes for solid organ transplant recipients. Relevant medical databases were searched to identify RCTs in solid organ transplantation comparing mTOR inhibitors with an alternative therapy reporting on wound complications and/or lymphoceles. Methodological quality of RCTs was assessed. Pooled analyses were performed to calculate odds ratios (OR) and 95% confidence intervals (CI). Thirty‐seven RCTs in kidney, heart, simultaneous pancreas‐kidney and liver transplantation were included. Pooled analyses showed a higher incidence of wound complications (OR 1.77, CI 1.31–2.37) and lymphoceles (OR 2.07, CI 1.62–2.65) for kidney transplant recipients on mTOR inhibitors together with calcineurin inhibitors (CNIs). There was also a higher incidence of wound complications (OR 3.00, CI 1.61–5.59) and lymphoceles (OR 2.13, CI 1.57–2.90) for kidney transplant recipients on mTOR inhibitors together with antimetabolites. Heart transplant patients receiving mTOR inhibitors together with CNIs also reported more wound complications (OR 1.82, CI 1.15–2.87). We found a higher incidence of wound complications and lymphoceles after kidney transplantation and a higher incidence of wound complications after heart transplantation for immunosuppressive regimens that included mTOR inhibitors from the time of transplantation.

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Section: Discussionmentioning

confidence: 99%

Do wound complications or lymphoceles occur more often in solid organ transplant recipients on mTOR inhibitors? A systematic review of randomized controlled trials

Pengel¹,

Liu²,

Morris³

2011

Transplant International

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“…10 But because some mTORs lead to adverse effects (eg, wound healing delay and increased rate of biopsy-proven AR), 3,4,16 the immediate posttransplant replacement of CNIs with mTORs would be unpleasant; such replacement is better if it is used after 3 to 6 months. 3,4,7,17 Firstly, such strategy prevents CNI-induced nephrotoxicity and CAN in different organ transplants 9,18 ; secondly, it allows CNIs primary protection from AR 4,5 ; third, it prevents the adverse effects of mTOR inhibitors (eg, wound healing delay 4,5 ); and finally, it increases the number and effects of T-regulatory cells in prevention of the AR processes. 5,19,20,21 Several trials have been tried to define the exact effects of such conversion.…”

Section: Introductionmentioning

confidence: 99%

Conversion of Calcineurin Inhibitors With Mammalian Target of Rapamycin Inhibitors After Kidney Transplant

Nikoueinejad

Soleimani²,

Mirshafiey³

et al. 2012

Exp Clin Transplant

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One way to overcome chronic allograft nephropathy induced by calcineurin inhibitors in immunosuppression protocols for organ transplants is to replace such inhibitors with mammalian target of rapamycin inhibitors, which are not clinically nephrotoxic because they have better renal function. If patients tolerate replacement, there could be a clear preference for mammalian target of rapamycin inhibitors as a maintenance immunosuppressant after renal transplant. This replacement could be sufficient if it were used for a certain time after calcineurin inhibitors. This review considers the conversion effects of calcineurin inhibitors with mammalian target of rapamycin inhibitors from the view point of kidney function during different periods after a kidney transplant.

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Comparison of Cyclosporine and Sirolimus Effects on Serum Creatinine Level Over Five Years After Kidney Transplantation

Soleimani

Kamkar

Nikoueinejad

et al. 2013

Transplantation Proceedings

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Conversion From Tacrolimus to Sirolimus-Based Immunosuppressive Regimen in Kidney Transplant Recipients. Preliminary Results

Cited by 3 publications

References 0 publications

Do wound complications or lymphoceles occur more often in solid organ transplant recipients on mTOR inhibitors? A systematic review of randomized controlled trials

Do wound complications or lymphoceles occur more often in solid organ transplant recipients on mTOR inhibitors? A systematic review of randomized controlled trials

Conversion of Calcineurin Inhibitors With Mammalian Target of Rapamycin Inhibitors After Kidney Transplant

Comparison of Cyclosporine and Sirolimus Effects on Serum Creatinine Level Over Five Years After Kidney Transplantation

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